Healthcare Provider Details

I. General information

NPI: 1124784889
Provider Name (Legal Business Name): VICTORIA FRANTZ MARRIAGE & FAMILY THERAPY PROF. CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2021
Last Update Date: 09/21/2023
Certification Date: 09/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3968 FAIRWAY AVE
STUDIO CITY CA
91604-2305
US

IV. Provider business mailing address

3968 FAIRWAY AVE
STUDIO CITY CA
91604-2305
US

V. Phone/Fax

Practice location:
  • Phone: 818-724-7363
  • Fax: 818-762-8985
Mailing address:
  • Phone: 818-724-7363
  • Fax: 818-762-8985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. VICTORIA D FRANTZ
Title or Position: CEO
Credential: LMFT
Phone: 818-724-7363